Effect of a Very-Low-Calorie Ketogenic Diet on Circulating Myokine Levels Compared with the Effect of Bariatric Surgery or a Low-Calorie Diet in Patients with Obesity.

Sajoux Sajoux,Gomez-Arbelaez Gomez-Arbelaez,Zulet Zulet,Castro Castro,Martinez Martinez,Abete Abete,Lorenzo Lorenzo,Crujeiras Crujeiras,Tinahones Tinahones,Casanueva Casanueva,Baltar Baltar,Portillo Portillo

doi:10.3390/nu11102368

Abstract

The preservation of muscle mass and muscle function after weight loss therapy is currently a considerable challenge in the fight against obesity. Muscle mass secretes proteins called myokines that have relevant functions in the regulation of metabolism and health. This study was aimed to evaluate whether a very low-calorie ketogenic (VLCK) diet may modulate myokine levels, in addition to changes in body composition, compared to a standard, balanced low-calorie (LC) diet or bariatric surgery in patients with obesity. Body composition, ketosis, insulin sensitivity and myokines were evaluated in 79 patients with overweight/obesity after a therapy to lose weight with a VLCK diet, a LC diet or bariatric surgery. The follow-up was 6 months. The weight loss therapies induced changes in myokine levels in association with changes in body composition and biochemical parameters. The effects on circulating myokine levels compared to those at baseline were stronger after the VLCK diet than LC diet or bariatric surgery. Differences reached statistical significance for IL-8, MMP2 and irisin. In conclusion, nutritional interventions or bariatric surgery to lose weight induces changes in circulating myokine levels, being this effect potentially most notable after following a VLCK diet.

Highlights

Obesity is a worldwide health problem and is considered to be a global epidemic [1,2,3]
The very low-calorie ketogenic (VLCK) diet induced a 20 kg reduction of total body weight, compared with 38 kg induced by the bariatric surgery and 9 kg after the LC diet
This loss in total body weight induced after weight loss therapies was due to both, a loss of fat mass (Figure 1b) and fat-free mass (Figure 1c)

Summary

Introduction

Obesity is a worldwide health problem and is considered to be a global epidemic [1,2,3]. Excess body weight is associated with cardiometabolic diseases and certain types of cancer, and weight loss can ameliorate or eliminate the metabolic risk factors related to these morbidities [1,2,3,4]. Diet-induced weight loss is used as treatment for obesity; the main problem of these diets is that high amount of fat-free mass—mainly skeletal muscle mass [5]—is lost together with the fat mass [4,6]; this may increase the risk of sarcopenic obesity [4,6,7]. Sarcopenic obesity imposes a double impact on health because the reduction in muscle mass and muscle strength is a cause of cardiometabolic disorders [6] and other obesity-related diseases. Bariatric surgery results in rapid and massive weight loss (>20% of total body weight) [4] and appears to accelerate the loss of fat-free mass relative to total body or fat mass loss, especially during the first six months after surgery [9]

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